Subcutaneous Versus Sublingual Immunotherapy for Allergic Rhinitis and/or Asthma

Nerin Nadir Bahceciler; Nazan Cobanoglu

Immunotherapy. 2011;3(6):747-756.

Effector Cells

Moreover, SCIT has been shown to decrease the numbers of effector cells at mucosal sites, both during seasonal allergen exposure and after allergen challenge,^[91,94] as well as reducing effector cell reactivity in vitro.^[83]

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Executive Summary

Allergen-specific Subcutaneous Immunotherapy & Sublingual Immunotherapy

Subcutaneous immunotherapy (SCIT) and sublingual immunotherapy (SLIT) improve symptoms in allergic rhinitis and/or asthma.
SCIT and SLIT decrease medication use in allergic rhinitis and/or asthma.
SCIT and SLIT improve specific bronchial hyper-reactivity in asthma.

Safety

Fatal systemic reactions may occur on rare occasions during SCIT.
SLIT may rarely cause oral itching, irritation, nausea, dyspnea and abdominal pain.

Immunological Mechanisms of Specific Immunotherapy

Upregulation of allergen-specific IgG and IgA.
Downregulation of allergen-specific IgE.
Redirecting allergen-specific Th2 responses to Th1/Treg profile.

SCIT versus SLIT

Both routes of immunotherapy are clinically efficient.
Immunological mechanisms of SCIT and SLIT are similar.

Future Directions

SLIT is a safer route of immunotherapy.
Oral mucosal dendritic cells are targets for adjuvants in SLIT to improve immunogenity.

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